SHOPKO STORES OPERATING CO LLC (NPI# 1568761484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568761484 |
| Entity Type | Organization |
| Organization Name | SHOPKO STORES OPERATING CO LLC |
| Other Organization Name | SHOPKO PHARMACY 605 |
| Practice Address |
340 Highway 65 S Mora MN 55051-1619 |
| Practice Telephone | 3206795950 |
| Practice Fax Number | 3206795956 |
| Mailing Telephone | 3206795950 |
| Mailing Fax Number | 3206795956 |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |
| Authorized Official Name | MICHAEL BETTIGA (EXECUTIVE VICE PRESIDENT AND COO) |
| Authorized Official Telephone | 9204294297 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
263662 | MN | Suppliers |
| Other Name | Type Code |
|---|---|
| ShopKo Pharmacy 605 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275017907 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1166 W Sunset Drive, Suite F100, Waukesha, WI 53189 | 2018-09-19 |
| 1871076968 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 1810 Jackson St, Oshkosh, WI 54901-2204 | 2018-09-13 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912454505 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 908 Nw 6th St, Tulia, TX 79088 | 2016-09-01 |
| 1821545419 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 67 Selkirk Way, Oldtown, ID 83822 | 2016-09-01 |
| 1740736586 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 94 North 400 East, Delta, UT 84624 | 2016-08-31 |
| 1639625064 | Shopko Stores Operating Co LLC | Pharmacy | 1001 N Center Ave, Hardin, MT 59034-1101 | 2016-08-26 |
| 1649726076 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 1635 E Highway 40, Ballard, UT 84066-5217 | 2016-08-26 |
| 1841745155 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 301 E Us Highway 20, Gordon, NE 69343-1650 | 2016-08-17 |
| 1821441205 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 6355 Main St, Bonners Ferry, ID 83805-8519 | 2016-07-20 |
| Street Address |
340 HIGHWAY 65 S |
| City | MORA |
| State | MN |
| Zip Code | 55051-1619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588618706 | Pamida Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 340 Highway 65 S, Mora, MN 55051-1619 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801407085 | Anna Insley | Pharmacist | 301 Mn-65, Inpatient Pharmacy, Mora, MN 55051 | 2020-08-12 |
| 1609286368 | Love The Journey Inc | Clinic/Center | 23 Pine St N, Mora, MN 55051 | 2014-05-04 |
| 1386981637 | Urology Associates, Ltd. | Urology | 244 7th Street North, Mora, MN 55051 | 2013-01-07 |
| 1710236138 | Rebecca Suzanne Autio | Nurse Practitioner | 301 Highway 65 South, Mora, MN 55051 | 2012-08-30 |
| 1154639128 | Augustana Senior Development II | Assisted Living Facility | 170 Valhalla Circle, Mora, MN 55051 | 2010-09-23 |
| 1306064423 | Matthew Gordon Allen | Family Medicine | 331 South Highway 65, Mora, MN 55051 | 2007-04-23 |
| 1942359278 | Ralph Dale Swenson | Dentist | 620 S Union, Mora, MN 55051 | 2007-01-09 |
| 1376620013 | Mora Chiropractic Clinic P.C. | Chiropractor | 114 W Maple Ave, Mora, MN 55051 | 2006-11-01 |
| 1629181094 | Janice Lea Fleming | Internal Medicine | 301 S Hwy 65, Kanabee Hospital, Mora, MN 55051 | 2006-08-17 |
| 1467407502 | James Matthew Williams | Dentist | 620 S Union St, Mora, MN 55051 | 2006-05-24 |
| Find all providers in zip 55051 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457880114 | Bestcare Pharmacy-mora, LLC | Pharmacy | #3 A033 Bestcare Pharmacy-mora LLC, Mora, NM 87732 | 2017-06-07 |
| 1841761871 | County of Kanabec | Pharmacy | 301 Highway 65 S, Mora, MN 55051-1899 | 2018-12-17 |
| 1194101766 | Coborns Inc | Pharmacy | 710 Frankie Ln, Mora, MN 55051-1914 | 2015-08-06 |
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| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.